乳腺癌术后患者家庭复原力水平及影响因素的纵向研究

Family resilience and its influencing factors among postoperative breast cancer patients:a longitudinal study

目的了解乳腺癌患者术后6个月内家庭复原力水平变化轨迹及其影响因素。方法采用纵向研究设计,分别于术后确诊期(T0)、术后1个月(T1)、术后3个月(T2)、术后6个月(T3)4个时间点,应用患者一般资料调查表、家庭复原力量表、医学应对方式问卷、社会支持评定量表对222例术后乳腺癌患者进行随访调查。结果4个时间点乳腺癌患者家庭复原力总分依次为(98.95±11.31)分、(98.05±11.08)分、(99.38±10.57)分、(100.69±9.33)分。经广义估计方程分析,影响患者家庭复原力变化趋势的因素有:学历、居住地、在职状况、家庭月收入、子女数量、疾病分期、面对应对、社会支持(均P<0.05)。结论乳腺癌患者术后6个月家庭复原力得分随着时间变化整体呈升高趋势,应重点关注学历低、居住偏远、无工作、家庭条件较差的患者,制定针对性干预策略,提高患者家庭复原力水平,促进家庭应对和疾病适应。

Objective To investigate the change track of family resilience level in breast cancer patients 6 months after surgery,and to analyze its influencing factors.Methods A longitudinal study was conducted to follow up 222 postoperative breast cancer patients at 4 time points:the postoperative diagnosis period(T0),1 month after the surgery(T1),3 months after the surgery(T2)and 6 months after the surgery(T3),using a general information questionnaire,the Family Resilience Assessment Scale(FRAS),the Medical Coping Modes Questionnaire(MCMQ),and the Social Support Rating Scale(SSRS).Results The participants′total scores of FRAS at four time points were(98.95±11.31)points,(98.05±11.08)points,(99.38±10.57)points and(100.69±9.33)points respectively.The result of the analysis of generalized estimation equation showed that,the factors affecting the change trend of family resilience were educational background,place of residence,employment status,monthly family income,number of children,disease stage,confrontive coping and social support(all P<0.05).Conclusion Family resilience scores of breast cancer patients during 6 months after surgery display an overall increasing trend with time changing.Those patients with low educational background,remote living,no job and poor family conditions should be paid more attention,and it is necessary to develop targeted intervention to improve their level of family resilience,and promote family coping and adaptation to the disease.